Lecture 8 - Elbow ax Flashcards
3 joints that make up the cubital articulations
Ulnohumeral
Radiohumeral
Superior radioulnar
Primary role of the elbow
Help position the hand in the appropriate location to perform its function
Type of joint for ulnohumeral
Uniaxial hinge joint
Ulnohumeral joint - rest pos. + close packed + capsular
Resting position = 70d elbow flexion, 10d supination
Close packed position = extension with supination
Capsular pattern = flexion, extension
Type of joint for radiohumeral
Uniaxial hinge joint between capitulum and head of radius
Radiohumeral joint - rest pos. + close packed + capsular pattern
Resting position = elbow fully extended and forearm fully supinated
Close packed position = elbow flexed to 90 and forearm supinated to 5
Capsular pattern = flexion>extension>supination>pronation
Type of joint for superior radioulnar
Uniaxial pivot joint
Ligament holding the superior radioulnar in place
Annular ligaments
Superior radioulnar - rest pos. + close packed + capsular pattern
Resting position = 35 supination and 70 elbow flexion
Close packed position = 5 supination
Capsular pattern = equal limitation of supination and pronation
name the 3 ligaments of the elbow
UCL
RCL
Annular lig.
Normal carrying angles for male and female
Male = 5 to 10 degrees
Female = 10 to 15 degrees
> 15 d = cubitus valgus
< 5 to 10 degrees = cubitus varus
Functional assessment of elbow positioning
Between 30 and 130d of elbow flexion
Between 50d of pronation and 50d of supination
Examples of functional assessment
Turning door knob
Throwing a ball
Lifting objects
Carrying grocery bags
Push-up
Microtrauma or macrotrauma is the cause for epicondylitis?
microtrauma (repetitive)
Tennis elbow
Lateral epicondylitis
Golfer’s elbow
Medial epicondylitis
Name the 3 tests for lateral epicondylitis
Cozen’s test
Mill’s test
Maudsley’s test
Joint dysfunction - radiohumeral, how to test?
Place pt in position of pain -> radially deviates (compresses radius against humerus)
Joint dysfunction - ulnohumeral, how to test?
Position at point of pain -> ulnar deviation (compresses ulna against humerus)
Tests for ulnar nerve (3)
Tinel’s sign
Wartenburg’s - add of 5th finger
Elbow flexion test
Tests for median nerve (2)
Resisted pronator teres
Pinch grip (ant. interosseous n.)
Name the 3 reflexes to test at elbow
Biceps (C5-C6)
Brachioradialis (C5-C6)
Triceps (C7-C8)
Radial n. palsy other name
Saturday night palsy
Cause and sx of radial n. palsy
Cause: fx at humerus or compression in radial groove
Sx: wrist drop, weak sup. sensory loss in forearm, inability to extend fingers
Posterior interosseous n. syndrome cause
Compression by supinator (arcade of frohse)
Sx of post. int. n. syndrome
Inability to extend fingers at MCP
Normal sensation, but extensor carpi ulnaris affected
Pronator teres syndrome affects which nerve
Median nerve (C6-C8, T1)
Sx of pronator teres syndrome
- Pain in forearm
- Weakness in hand grip
- Pain NOT worse at night
- Numbness and tingling in index and thumb
Difference between carpal tunnel syndrome and pronator teres syndrome?
Carpal tunnel = pain gets worse at night
Sx of anterior interosseous n. syndrome
- Weakness in flex. digitorum profundus & longus
- “Pinch attitude”
- No abnormal or reduced sensation
What nerve is affected by cubital tunnel syndrome
Ulnar n. (C7-C8, T1)
Sx of cubital tunnel syndrome
Numbness/tingling in ulnar aspect of hand
Weakness in hand grip
Atrophy in hypothenar and 1st web space
Sensory loss (ulnar)
2 tests that will reveal cubital tunnel syndrome
Benediction hand
Froment’s sign
